Key result
Patients with atrial fibrillation recurrence after pulmonary vein ablation had a significantly larger epicardial fat volume compared to those without recurrence (176.4 vs 109.8 mL, p=0.02).
Why the study?
Pulmonary vein ablation remains associated with a high rate of recurrence, prompting the need to identify clinical and imaging-based features that predict this risk.
Do imaging-based features including epicardial fat volume and indexed atrial volumes predict the risk of recurrence after pulmonary vein ablation in patients with atrial fibrillation?
Observational (n=24)
No
Do imaging-based features including epicardial fat volume and indexed atrial volumes predict the risk of recurrence after pulmonary vein ablation in patients with atrial fibrillation?
Absolute Event Rate: 176.4% vs 109.8%
p-value: p=0.02
Increased epicardial fat volume and indexed atrial volumes assessed by CT are associated with a higher risk of atrial fibrillation recurrence one year after pulmonary vein ablation.
May inform ablation risk stratification in AF; leaves open need for prospective validation before clinical adoption.
Background: Atrial fibrillation (AF), a common arrhythmia in clinical practice, is associated with a high rate of complications and an increased risk for thromboembolic events. Pulmonary vein ablation is a new therapeutic option to cure AF; however, it remains associated with a high rate of recurrence. In this study we aimed to identify the clinical characteristics and imaging-based features that may predict the risk of recurrence after pulmonary veins ablation in atrial fibrillation. Materials and method: Twenty-four patients with paroxysmal and persistent AF, who underwent radiofrequency catheter ablation and a 12-month follow-up were included in the study. Group 1 included 8 patients with AF recurrence, and group 2 included 16 patients with no AF recurrence. In all cases, cardiovascular risk factors, ejection fraction, left atrial diameter, atrial volumes, and epicardial fat volume were analyzed. Results: CT analysis revealed that patients with AF recurrence presented a significantly larger mean index of left atrial volume (59.57 ± 8.52 mL/m2 vs. 49.99 ± 10.88 mL/m2, p = 0.04), right atrial volume (58.94 ± 8.37 mL/m2 vs. 43.21 ± 6.4 mL/m2, p<0.0001), and indexed bi-atrial volume (118.5 ± 15.82 mL/m2 vs. 93.19 ± 16.42 mL/m2, p = 0.005). At the same time, CT analysis of the epicardial adipose tissue volume indicated that patients with AF recurrence have a larger amount of epicardial fat than those without AF recurrence (176.4 ± 100.8 mL vs. 109.8 ± 40.73 mL, p = 0.02). Conclusion: Left atrial diameter, indexed atrial volumes, and epicardial fat volume may be used as factors to identify patients at risk for developing recurrence after pulmonary vein ablation.
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Blîndu et al. (2020) conducted an observational in Atrial fibrillation (n=24). Epicardial fat volume vs. Patients without AF recurrence was evaluated on Epicardial fat volume (p=0.02). Patients with atrial fibrillation recurrence after pulmonary vein ablation had a significantly larger epicardial fat volume compared to those without recurrence (176.4 vs 109.8 mL, p=0.02).
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